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Physical Dx > Exam 2: Pulmonary > Flashcards

Exam 2: Pulmonary Flashcards

1
Q

How many lobes are in the right lung?

A

3

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2
Q

How many lobes are in the left lung?

A

2

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3
Q

Where is lung apices located?

A

2-4cm above the clavicle

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4
Q

Where does the trachea bifurcate into R and L bronci?

A

Anteriorly- sternal angle

Posteriorly- T4

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5
Q

What is the normal respiration rate?

A

14-20 breaths/min

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6
Q

What is it called when the diaphragm contracts, chest wall expands, and negative intrathoracic pressure draws
air into lungs?

A

Inspiration

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7
Q

What is it called when the diaphragm relaxes, chest wall contracts, intrathoracic pressure normalizes, air leaves lungs?

A

Expiration

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8
Q

What is the order of techniques?

A 
IPPA
Inspection
Palpation
Percussion
Auscultation
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9
Q

What are common causes of tracheal deviation?

A

Large pleural effusion, large pneumothorax, mass/tumor

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10
Q

What is pectus carinatum?

A

Convex anterior chest

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11
Q

What is pactus excavatum?

A

Concave anterior chest

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12
Q

What is barrel chest?

A

Increased A-P diameter

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13
Q

What is flail chest?

A

Rib fractures cause paradoxical movement of chest wall

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14
Q

What is kyphosis?

A

Abnormal forward curvature of spine

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15
Q

What is scoliosis?

A

Abnormal lateral curvature of the spine

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16
Q

What is bradypnea? What are some causes?

A

Slow respirations
<12 breaths/min

-Diabetic coma, drug induced respiratory depression

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17
Q

What is tachypnea? What are some causes?

A

Rapid respirations
>20 breaths/min

-Restrictive lung disease, elevated diaphragm, pain

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18
Q

What is hyperventilation?

A

Faster, deeper respiration

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19
Q

What is sighing?

A

Periodic deeper breaths

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20
Q

What is obstructive breathing?

A

Prolonged expiration

2/2 increased airway resistance

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21
Q

What would you call rapid and deep respiration

caused by metabolic acidosis?

A

Kassmaul breathing

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22
Q

What would you call irregular, unpredictable, shallow or deep, with intermittent apnea?

A

Biot’s breathing

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23
Q

What would you call periods of gradually increasing and decreasing depth of respirations
with periods of apnea?

A

Cheyne-Strokes breathing

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24
Q

What would you call the absence of spontaneous respiration?

A

Apnea

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25
Q

What would you call crackling/grating feeling or sound?

A

Crepitus

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26
Q

A patient presents with air from lung/chest tracts along tissue planes, swelling of eyelids, cheeks, lips, neck, and chest. What do you suspect?

A

Subcutaneous Emphysema

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27
Q

What can cause decreased fremitus?

A 
Obstructed bronchus
COPD
Pleural effusion
Lung fibrosis
Pneumothorax
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28
Q

What can cause increased fremitus?

A

Pneumonia/consolidation

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29
Q

How many levels of percussion and auscultation should you do anteriorly, posteriorly, and laterally?

A

Anterior- 3
Posterior- 4
Lateral- 1

30
Q

What is the purpose of percussion?

A

Determine if underlying tissue are air-filled, fluid-filled, or solid (7cm deep)
Detect areas of tenderness

31
Q

What type of sound would you hear when percussing over air areas (lungs)?

A

Resonant

32
Q

What type of sound would you hear when percussing over solid areas (liver)?

A

Dull

33
Q

What type of sound would you hear when percussing over fluid-filled areas (bone/muscle)?

A

Flat

34
Q

What type of sound would you hear when percussing over hollow areas (stomach)?

A

Tympani

35
Q

What type of lung issue would produce a hyper-resonant tone, very loud intensity, low pitch, and long duration?

A

COPD or pneumothorax

36
Q

What type of lung issue would produce a resonant tone, loud intensity, low pitch, and long
duration?

A

Chronic bronchitis

37
Q

What type of lung issue would produce a tympanic tone, loud intensity, high pitch, and moderate
duration?

A

Large pneumothorax

38
Q

What type of lung issue would produce a dull tone, medium intensity, moderate pitch, and moderate
duration?

A

Pneumonia or pleural effusion

39
Q

What type of lung issue would produce a flat tone, soft intensity, high pitch, and short duration?

A

Pleural effusion

40
Q

What is the purpose of auscultation?

A

Determine whether there is normal air-flow, airway
obstruction, or abnormal air or fluid within the chest or
lungs

41
Q

What location of breath sounds has equal inspiration and expiration durations, a very loud intensity, and high
pitch?

A

Tracheal

42
Q

What location of breath sounds has expiration longer than inspiration?

A

Bronchial (over manubrium)

43
Q

What location of breath sounds has equal inspiration and expiration durations, a moderate intensity, and moderate pitch?

A

Broncho-vascular
Ant: 1st & 2nd interspaces
Post: interscapular

44
Q

What location of breath sounds has inspiration longer than expiration?

A

Vesicular (most of peripheral lung)

45
Q

Patient says “99” during auscultation and you are listening for a louder sound. What test is this?

A

Bronchophony

46
Q

Patient says “EE” during auscultation and you are listening for an “AAY” sound. What test is this?

A

Egophony

47
Q

What is it called when sounds are superimposed on usual breath sounds?

A

Adventitious

Ex: Crackles, rhonchi, wheezes

48
Q

During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. What is this called?

A

Crackles

49
Q

During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. They are soft, high pitched and very brief. What is this called?

A

Fine crackles

50
Q

During auscultation you hear intermittent, nonmusical, brief, velcro-like sounds. They are louder, lower pitched and brief. What is this called?

A

Coarse crackles

51
Q

During auscultation you hear musical low pitched, snoring wheeze that clears with cough. What is this called?

A

Rhonchi

52
Q

During auscultation you hear high pitched, hissing, shrill, whistling. What is this called?

A

Wheeze

53
Q

What is stridor?

A

Inspiratory wheeze (larynx/tracheal obstruction)

54
Q

Crackle sounds are indicative of what?

A

Bronchitis, pulmonary fibrosis, CHF

55
Q

Ronchi sounds are indicative of what?

A

Large airway secretions, chronic bronchitis

56
Q

Wheeze sounds are indicative of what?

A

Asthma, COPD, chronic bronchitis, bronchus obstruction

57
Q

What does pleural friction rub sound like and what causes it?

A

Crackle-like creaking sounds from inflamed pleural surfaces rubbing together.
Recent URI, pneuomia

58
Q

What does mediastinal crunch (hamman’s sign) sound like and what causes it?

A

Precordial crackles in sync with heartbeat, not respiration

Mediastinal emphysema

59
Q

At what level of the ribs should you place your thumbs to test respiratory expansion?

A

10th ribs

60
Q

What are palpable vibrations transmitted through bronchiopulmonary tree to chest wall with patient verbalization?

A

Fremitus

61
Q

What is fluid collection within the chest but outside

the lung, causing lung compression?

A

Pleural effusion

62
Q

What is air collection within the chest but outside the

lung, causing lung compression?

A

Pneumothorax

63
Q

What is overdistention of distal airspaces, resulting in limited expiratory flow
and lung hyperinflation?

A

COPD

Chronic Obstructive Pulmonary Disease

64
Q

What is alveoli filled with fluid/blood/pus increasing the density and opacity of the lung tissue?

A

Consolidation/infiltrate

65
Q

Patient presents with dull percussion, bronchial and crackle breath sounds, increased transmitted voice sounds, and increased tactile fremitus. What do you suspect?

A

Consolidation- Pneumonia

66
Q

Patient presents with dull to flat percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?

A

Pleural effusion

67
Q

Patient presents with hyperresonant or tympanic percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?

A

Pneumothorax

68
Q

Patient presents with diffusely hyperresonant percussion, decreased breath sounds, decreased transmitted voice sounds, and decreased tactile fremitus, and increaed AP diameter of chest. What do you suspect?

A

COPD

69
Q

Patient presents with resonant percussion, obscured breath sounds due to high pitched wheezes, decreased transmitted voice sounds, and decreased tactile fremitus. What do you suspect?

A

Asthma

70
Q

Patient presents with resonant percussion, vesicular breath sounds with some crackles, wheezes or rhonchi, normal transmitted voice sounds, and normal tactile fremitus. What do you suspect?

A

Chronic bronchitis

71
Q

What is the sternal angle or angle of Louis?

A

The bony ridge that joins the manubrium and sternal body

72
Q

Are the intercostal spaces above or below their correspondent ribs?

A

Below

Physical Dx (14 decks)

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